Deciding between Exocad & 3Shape Dental System & More

[DrMJF]

I need some input from the lab techs...
I'm a fairly tech-savvy dentist and do a lot of my own tooth, tissue, and bone-supported stacking surgical guide designs, screw-retained implant provisional crowns on Ti-bases, and 3D print my own occlusal appliances and lab-designed all-on-x temps. I'm just getting into CAM, and the BlueSkyPlan software I've been using isn't up to snuff for more advanced processes like designing/exporting custom titanium/zirconia abutments and doesn't support CAM nesting (as far as I'm aware).
I'm looking at a Roland DWX-53DC (or DWX-52 DCi) and DWX-42W to support my dry and wet CAM needs, respectively. I have no plans to do same-day crowns. I run 3 (soon to be 4) offices and have roughly 30-60 fixed units and 10-15 arches of removable weekly, total. **We use 3Shape Trios scanners in each office**
My question: given these positions, should I look at investing into Exocad or 3Shape CAD software?
I've heard 3Shape is more intuitive because it keeps you in a fixed workflow and might be more friendly for somebody who doesn't do design full-time. I also like the AI design feature and the ability to outsource design to meet volume demands. The lab management software (LMS) feature sounds helpful to somebody with busy practices and cases coming in and out constantly. It also seems like it would play well with our office Trios scanners.
BUT...
every lab tech I've spoken to swears by Exocad. I know a prosthodontist who uses it too. I would need to be able to design All-On-X prostheses with ASC (Vortex screws), dentures, partials, abutments, and implant/tooth crown&bridge. To me, money is secondary to efficiency, throughput, and ease of task-delegation/training.
1. Help me decide between the two options!
2. Any recommendations for sintering / crystallization ovens? I was looking at the Ivoclar S1 and CS2, respectively. Is the CS-4 good to do both?
3. Any recommendations for better/different mills from the ones I listed?

Thanks in advance!

 

[TheLabGuy]

What are you doing for custom abutments nowadays?

Preat, for two reasons...they can accept (have libraries for) any scanbody from any manufacturer which is huge!!! Plus, only for labs and price was almost the same as Tru.

 

[mmbh]

Preat, for two reasons...they can accept (have libraries for) any scanbody from any manufacturer which is huge!!! Plus, only for labs and price was almost the same as Tru.

Sounds great. Accepting all those scan bodies is a huge benefit. Maybe I'll give them a shot.

 

[JonnyLathe]

Ultimately you'll be the most efficient with the software your (future?) lab tech is used to.

That being said, when you mention things like full-arch, vortex screws, etc, it makes me think you're doing immediate load/straight to MUA cases. In my experience exocad is much friendlier with non-official scan body libraries needed for different photogrammetry/grammetry systems. It's also much more streamlined for full-arch.

When I was designing in 3shape you kind of had to trick the system into letting you be more flexible by utilizing several different modules (maybe it's changed) and going back to change things after the fact was a chore laden with load times and errors.

 

[TrinidentDLNick]

The owner/master ceramist of the lab I work at always tells me how he started the lab 45+ years ago with the CDT degree he earned from LSU Dental School and a $7000 blessing (which he paid back quickly) from his parents. That chunk allowed him to build out his lab space, and buy all the equipment/tools he needed to get off the ground.
flash forward to today where $7000 buys one small 3D printer or about 2years dongle service from 3shape
20 arches a month (designed in house and placed by yourself I'm assuming) amongst whatever other work you intend on doing would put you into a tax bracket that I know absolutely nothing about, but I'd venture to say you could probably comfortably purchase/afford whichever design software and milling machines and various other equipment and staff you could possibly ever need.

 

[MatPhil]

I am using both 3shape and Exocad. I like the open nature of Exocad. It will take any STL. 3Shape is very proprietory. It does not take STL files from any other systems. It will tag its files with proprietory code, and knows the difference. 3shpae is easy to work with like Iphone, while Exocad is like Android, in the sense that you have more options, and add libraries etc without worrying about freezing up

 

[grantoz]

this guy and skidoc should team up they can look at each other in the mirror of truth and see the reason why no one can help these guys.

 

[rlhhds]

Save yourself all the headaches that come with operating dental lab. You are the master of your craft we are the masters of our craft. Work with a great lab that understands what you need/want. We have several client that do the stuff you do. There was a learning curve for both sides when we started working with them. Now we know exactly what they want and how they want it. We are their "in house lab" that is offsite. They love us we love them. Cases just run smoothly between us as if we were right next to them chairside.

 

[Link]

With all this money you will be saving the only question I have for you is how much benefit will your patients be receiving in price break? You don't have to answer that question....we all know the answer is nothing. But who cares about them, IT'S all about ME. SAD!

 

[TheLabGuy]

With all this money you will be saving the only question I have for you is how much benefit will your patients be receiving in price break? You don't have to answer that question....we all know the answer is nothing. But who cares about them, IT'S all about ME. SAD!

Did you know that the word Allodoxaphobia is the fear of other people's opinions. It's a rare social phobia characterized by an irrational and overwhelming fear of what other people think...really wish I had it because you don't want me to tell you what I'm thinking right about now.

 

[lucyfer]

I went from 3shape fixed/implant modules to Exocad implant modules, now I’m back to 3shape using denture module and it reminded me how much I hate 3shape. Absolutely despise this software. 3shape has the company I work for testing out their new 2024 software and NOTHING has changed, same bugs same freezing same 3shape bullsh. I liked exocad because it felt like I could do anything on it.

 

[prosthotech]

I need some input from the lab techs...
I'm a fairly tech-savvy dentist and do a lot of my own tooth, tissue, and bone-supported stacking surgical guide designs, screw-retained implant provisional crowns on Ti-bases, and 3D print my own occlusal appliances and lab-designed all-on-x temps. I'm just getting into CAM, and the BlueSkyPlan software I've been using isn't up to snuff for more advanced processes like designing/exporting custom titanium/zirconia abutments and doesn't support CAM nesting (as far as I'm aware).
I'm looking at a Roland DWX-53DC (or DWX-52 DCi) and DWX-42W to support my dry and wet CAM needs, respectively. I have no plans to do same-day crowns. I run 3 (soon to be 4) offices and have roughly 30-60 fixed units and 10-15 arches of removable weekly, total. **We use 3Shape Trios scanners in each office**
My question: given these positions, should I look at investing into Exocad or 3Shape CAD software?
I've heard 3Shape is more intuitive because it keeps you in a fixed workflow and might be more friendly for somebody who doesn't do design full-time. I also like the AI design feature and the ability to outsource design to meet volume demands. The lab management software (LMS) feature sounds helpful to somebody with busy practices and cases coming in and out constantly. It also seems like it would play well with our office Trios scanners.
BUT...
every lab tech I've spoken to swears by Exocad. I know a prosthodontist who uses it too. I would need to be able to design All-On-X prostheses with ASC (Vortex screws), dentures, partials, abutments, and implant/tooth crown&bridge. To me, money is secondary to efficiency, throughput, and ease of task-delegation/training.
1. Help me decide between the two options!
2. Any recommendations for sintering / crystallization ovens? I was looking at the Ivoclar S1 and CS2, respectively. Is the CS-4 good to do both?
3. Any recommendations for better/different mills from the ones I listed?

Thanks in advance!

I am also a dentist who has an in house lab. We run both Exocad and 3Shape and Blueskyplan. It all depends on what you are trying to do, but there are limitations with each platform, one of which you’ve already mentioned regarding Blueskyplan. Just so you know, 3Shape is not friendly with photogrammetry, and depute 2 months working with their headquarters, they finally admitted they couldn’t make it work. 3Shape shines for single units and bridges, decent denture planning, and almost idiot-proof workflow. The downsides are that they nickel and dime you with huge renewal fees that are not optional, the idiot-proof workflow is also expert-proof, and perhaps worst of all, their software is poorly written regarding maximizing system resources (lots of crashes and poor multithreaded performance). We continue to use Implant Studio (large additional cost and annual renewal fees), and fixed work for natural teeth.

Regarding your choice of ills, I own the 52DCi, 53Dplus, 42Wplua, and Amann Girrbach Motion 2 system. If you do a lot of PMMA work, the Roland crushes the AG mill (not talking about their larger mills) in regards to consistency and predictability, but it takes almost 8 hours to mill a single full arch; dentures are as slow or slower. For temporary dentures we use the Roland mill to mill multilayered PMMA, and a Formlabs 4B to print the denture base (less than an hour). We are experimenting with resin temps for our fixed work, but the material costs are dramatically higher (especially for a misprint or redo), and it lacks the toughness of PMMA for anything full arch. By the way, you’ll need a resin printer anyways if you want to print your surgical guides.

We have a long term relationship with TruAbutment, and outsource all of our titanium or chrome cobalt milling to an outsource lab in Illinois, where I practice. I’ve always had an in house lab since I started, waxing all of my cases, casting all of my indirect restorations and substructures, and setting denture teeth. When I entered the world of implants in 2002, I quickly realized that only the most expensive technicians know anything about implant prosthetics, so was “forced” to go all in with my in house lab, even though I only operated a single practice. We were the first dental office to install the BruxirMill, which opened my eyes to the disconnect between what manufacturers promised and the actual output. Not saying anything negative about Glidewell (Jim Glidewell is a pioneer and legend), since we’ve has even worse disconnects with other established companies since.

Hope this helps.

 

[CoolHandLuke]

only the most expensive technicians know anything about implant prosthetics, so was “forced” to go all in with my in house lab

 

[prosthotech]

That was in 2002.

 

[CoolHandLuke]

and would you say the 23 years you've spent qualifies you as an implant technician, and do you charge more, or less, now that you know these things.

 

[prosthotech]

Hmmm…touchy feelings on this thread. If you were involved with implants or remember what implant prosthetics cost back in the early 2000’s, and especially for implant prosthetics from experienced technicians, you would know what I’m talking about. This is why Jim Glidewell dropped out of the implant market for over a decade. So, unless you were one of the “overpriced” labs that produced very average or worse implant prosthetics in the early 2000’s, I’m truly mystified why people are offended. I have zero problem calling out horrible dentists, and even myself, when I’ve made mistakes, which is more often than I care to admit. Professionals need to have thicker skins.

For context, before I attended dental school, I worked summers and evenings as a model prep and die prep technician. I continued to make the models at the University of Michigan for four years, and took all the optional experiences for anything lab related. I have never asked my technicians to do anything I was not able to do myself, and have personally made more full arch implant restorations than I can count. Early on, I trained my technicians on 3Shape and Exocad, and continue to work together when investigating and implementing new concepts and products. I have helped my implant technician earn his fellowship in the ICOI, and at some point in time, I’ll join him in obtaining my CDT, which I helped prepare him for. Whether all of this qualifies e as an implant technician is irrelevant since the technician serves at the order of the doctor. Having said all that, it has been my professional mission to make full arch implant therapy “affordable” to the semi-rural community where I practice.

For what it’s worth, my fees, in 2002 dollars, have actually gone done over the years, since any pricing is subject to the laws of supply and demand. It’s one thing to charge a $1000 lab fee for a “perfect” anterior crown, but when the work that was prevalent in the early 2000’s looked like mushroom caps at a cost that would be about $1200 per abutment with posterior crown in today’s dollars, even a newbie doctor can see that something’s not right.